Analysis On The Secondary Conversion Effect Of Guangxi G Hospital

Objective:Since the end of the 1980s,the problem of the conversion of China public hospitals was still in the stage of debate and discussion.Based on that,through the combination of theory and empirical,this study comprehensively analyzed the secondary conversion effects of Guangxi G Hospital based on external environment,restructuring process,management behavior and performance changes,so as to provide evidence-based references for conversion optimization strategy of Guangxi public hospital.Methods:This study applied literature research,case study analysis,qualitative interview and statistical analysis to comprehensively analyze the conversion effect of Guangxi G hospital.?1?Through literature research,this study summarized the public hospital restructuring policies,basic theories,major dilemmas,and constructed public hospital conversions black box model.?2?Based on the ESCP Paradigm,according to the principle of theoretical sampling,this study selected Guangxi G hospital as a sample case.And then the research and analysis of the conversion process and performance changes of Guangxi G hospital were conducted.?3?Through qualitative interview,combined with the Preker-Harding model,this paper qualitative analyzed the conversion process of Guangxi G hospital,and to understand the changes in the management behavior of G hospital.?4?This article descripted the market environment of Guangxi G hospital and performance changes of G hospital by the descriptive statistics method.?5?Through ITS analysis model,this research analyzed the performance both level and trend changes of Guangxi G hospital before and after the secondary conversion.?6?This study applied RSR method to comprehensively analyze the performance changes before and after the secondary conversion of Guangxi G hospital around the three level of medical quality,operational efficiency,and sustainable development.Results:?1?The content of the conversion policies were characterized by fragmentation and generality,and the rationality of conversion was mainly based on the theory of privatization and was influenced by economics and public management theory.The key point was a triangular relationship between power,responsibility and interests,which was coordination and game.The main dilemma of conversion was the contradiction between de-administration and re-administration,productivity and public welfare,as well as property rights system issues and stakeholder group issues.From the theoretical level,public hospital conversions black box model was constructed of government governance,market-social order,citizen acceptance and disease spectrum.?2?The Preker-Harding model showed that G hospital's four dimensions independent rights—decision-making power,market entry degree,residual claim rights,and accountability,were between the Corporatized hospital and the privatized hospital.However,the social function dimension was mainly reflected in the characteristics of the Budgetary hospital.G hospital showed a focus on finance,employee compensation,patient satisfaction,short-term goals,etc.?3?ITS analysis model indicated that the performance levels and trends changes of before and after the secondary conversion were as follows:In terms of medical quality,the ratio of the number of outpatients to the number of discharged patients,the average level of scheduled appointments of outpatients were statistically significant difference??₂ values were-2.015,3.717respectively,both P?27?0.05?.Large medical equipment positive rate of inspection,the coincidence rate of outpatient and discharge diagnosis,the proportion of basic drug purchases,basic drug income to total drug income were reported statistically significant difference??₃ values were-1.255,0.955,-1.432,-1.442respectively,both P?27?0.05?.In terms of operational efficiency,the number of total visits,average hospitalization days,average hospitalization expenses,asset-liability ratio,and total return on assets were showed statistically significant difference??₂ values were-21082.430,-1.013,-0.126,-8.686,-7.701respectively,both P?27?0.05?.The daily work burden of each physician,average hospitalization day,and asset-liability rate were showed statistically significant difference(?₃ values were 0.260,-0.121,-4.193 respectively,?both P?27?0.05?.In terms of sustainable development,the ratio of physician to nurse,outpatient satisfaction were statistically significant difference??₂ values were-0.118,-2.840,both P?27?0.05?.The number of physicians,the ratio of physician to nurse were statistically significant difference??₃ values were-8.097,-0.043respectively,both P?27?0.05?.?4?During 2013-2018,medical quality the quarterly averages of RSR value were 0.337,0.460,0.552,0.560,0.626,0.592 respectively.Operational efficiency the quarterly averages of RSR value were 0.410,0.392,0.452,0.540,0.666,0.699 respectively,and the quarterly average of RSR value in 2014 was at the minimum when the medical group join in G hospital.Sustainable development the quarterly averages of RSR value were 0.274,0.549,0.488,0.476,0.618,0.794,respectively,with the medical group showed a downward trend within 3 years?2014-2016?,and then turned to an upward trend.?5?The results of qualitative interviews showed that the main form of the second conversion of G hospital was the personnel placement and capital investment of F Medical Group,which is managed by F Medical Group.However,after the second conversion the G hospital had some problems,such as shortage of talents and weak scientific research ability.conclusion:?1?The subdivision and implementation of the conversion policy of public hospitals was not enough.?2?Going out of the main dilemma of public hospital conversion was a process of deconstructing the black box.?3?The process of the conversion of G hospital was in a mixed state of between corporatized unit and the privatized unit.?4?After the conversion of the G hospital,the performance was stability to better while the part of problems was coexisted.Recommendation:?1?The content of the conversion policy of public hospitals needs to be further subdivided.?2?The function positioning of public hospitals conversion needs to be further explored.?3?Cask effect in public hospital conversion requires further attention.